In week 15 (April 12–18, 2021), epidemiological indicators remained at very high levels, with an average of 32,400 new cases per day; however, a decline was observed in most indicators, suggesting the beginning of a slowdown in viral circulation across all regions of mainland France. However, the decline in testing rates calls for caution in interpreting the dynamics of the epidemic. Furthermore, hospital pressure remains high across the entire mainland, and mortality rates continue to rise—a trend expected given the intensity of the epidemic over the past few weeks. In this context, adherence to individual prevention measures, compliance with collective containment measures, and the acceleration of vaccination remain key priorities in addressing the still very high level of viral circulation.

The epidemic appears to be slowing

Nationally, 226,512 new cases were confirmed, representing an average of nearly 32,400 cases per day. The incidence rate for Week 15 was 337 per 100,000 inhabitants, down from the adjusted rate for Week 14 (411, a decrease of 18%). The testing rate was also lower compared to the adjusted testing rate for week 14 (3,423 per 100,000 inhabitants versus 4,471, a decrease of 23%). This decrease, observed across all age groups, was more pronounced among those aged 0–14 (-45%), likely due to the suspension of school-based testing campaigns following the closure of educational institutions.

A beneficial effect of the restrictive measures remains to be confirmed

In the group of departments where enhanced measures were implemented starting March 20, 2021 (Group 1), the incidence rate of confirmed cases has been decreasing since the end of Week 13 (-6% in Week 14 and -18% in Week 15). The incidence rate is also decreasing in the departments where these measures were implemented on March 27, 2021 (Group 2), with an initial decline (-8%) in Week 14 that continued into Week 15 (-19%). In the last group, where measures were implemented on April 3, 2021, the incidence rate decreased (-16%) in week 15.

The favorable trend in viral circulation across the three groups of departments observed 7 to 10 days after the measures were implemented is consistent with the hypothesis that these measures have a beneficial effect. However, this trend must be viewed in light of the observed decline in the testing rate, which is greater than that of the incidence rate (-22% for groups 1 and 3 and -28% for group 2 in week 15), and could skew the evolving trend toward stabilization or even improvement that does not reflect reality. Based on the latest available data, incidence and testing rates appear to be stabilizing across the three groups of departments. The evolution of these indicators in the coming days will allow us to observe whether these trends are confirmed

Despite the decline in indicators, hospitals remain under significant strain

After an increase between weeks 10 and 13 and a stabilization in week 14, the number of reported new hospitalizations decreased slightly in week 15 (-4%). The number of reported new admissions of COVID-19 patients to critical care units decreased in week 15 (-6%), after having increased since week 08.

The number of people currently hospitalized remained at a high level, with 31,147 people hospitalized as of April 20 (versus 31,287 on April 13, a decrease of 0.4%), including 6,000 patients in critical care (versus 5,969, an increase of 0.5%).

The number of deaths from all causes and across all age groups was significantly higher than expected from week 40 of 2020 through week 14 of 2021. In week 13, the number of deaths was rising, with an excess of +14%. The number of deaths across all age groups was higher than expected in week 14 in five regions: Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté, Hauts-de-France, Île-de-France, and Provence-Alpes-Côte d’Azur (unconsolidated S14 data).

Variants under surveillance

Regarding variants of concern (VOCs), the latest results obtained via SI-DEP from screening RT-PCR tests indicate a stable situation:

• 82.3% corresponded to a suspected 20I/501Y.V1 variant (which emerged in the United Kingdom)

• 4.2% corresponded to a suspected 20H/501Y.V2 variant (which emerged in South Africa) or 20J/501Y.V3 variant (which emerged in Brazil)

• The results of the latest Flash surveys confirm the predominance of the 20I/501Y variant, followed by the 20H/501Y.V2 variant; the 20J/501Y.V3 variant remains very rare. The consolidated results of Flash Survey #6 and the preliminary results of Flash Survey #7 will be available next week.

These VOCs have been detected in all metropolitan regions. The proportion of suspected cases of the 20I/501Y.V1 variant was over 80% (among screened positive tests) in 67 metropolitan departments and over 90% in 23 of them. The proportion of suspected cases of the 20H/501Y.V2 or 20J/501Y.V3 variants was greater than 10% in four departments (Creuse, Moselle, Haute-Saône, and Vosges).

Other rarer SARS-CoV-2 variants are also subject to monitoring and risk assessments that are regularly updated by the National Reference Center for Respiratory Infections and Santé publique France. Some have already been detected in France and are subject to enhanced surveillance. These include the following variants: 20A/484K (lineage B.1.525), which has recently been detected more frequently in France, 20C/H655Y (lineage B.1.616), which was identified in Brittany in early 2021 as part of a hospital outbreak, and 19B/501Y (lineage A.27). The 20A/484Q variant (lineage B.1.617), which is believed to have emerged in India, has been detected in two travelers arriving from India and transiting through Guadeloupe, but no locally transmitted cases have been identified in France to date.

Maintain social distancing measures despite progress in vaccination

As of April 20, 2021, 13,018,378 people have received at least one dose of the COVID-19 vaccine and 4,850,310 people have received two doses, representing 19.4% and 7.2% of the population in France, respectively.

Vaccination appears to be accompanied by a relaxation of preventive measures, even though it is important to maintain them. It remains essential that anyone experiencing symptoms suggestive of COVID-19 isolate immediately and get tested as soon as possible. The use of digital tools (TousAntiCovid) is recommended to strengthen contact tracing and rapid isolation measures.